Earliest Probable Case of Mueller-Weiss Disease From Ancient Egypt.

Mueller-Weiss disease is an alteration of the tarsal navicular that is primarily due to anomalous ossification of the bone and lateral deviation of the talar head associated with screw-like movement through the axis of the subtalar joint. This syndrome tends to be associated with various degrees of flatfoot and hindfoot valgus combined with subtalar joint varus. Ancient cases of Mueller-Weiss disease have not been described in specialized literature. We present the case of an adult male from the Hellenistic period (Ptolemaic dynasty; fourth to first century BC), the skeleton for which was found inside a sarcophagus in the archaeological site of Sharuna (middle Egypt) with Mueller-Weiss disease. The specimen is, in all likelihood, the earliest case of this type of foot pathology in the archaeological record.

[Tutankhamun: evidence-based paleopathology versus "curse of the pharaoh"]. / Tutanchamun: Evidenzbasierte Paleopathologie vs. "Fluch des Pharao".

AIMS: Several speculations exist regarding possible diseases of the juvenile Pharaoh Tutankhamun. In this review published paleopathological findings and artificial alterations as well as suggestions regarding underlying diseases were characterized. MATERIAL AND METHODS: A selective search of the literature was carried out in the PubMed data base in an arbitrary time interval from 1960 to 2013 (search terms: Tutankhamun, Pharaoh, paleopathology and mummy) and additional supplementary literature. RESULTS: Many artificial changes were a result of embalming and the examinations which have been performed since exhumation in 1922. Evidenced pathologies are craniofacial dysmorphia, bilateral alterations of the feet, malarial disease and an acute traumatic fracture of the knee. The cause of the knee fracture could no longer be reconstructed. Other trauma (e.g. skull fractures) or familial transmission of an eighteenth dynasty syndrome could not be confirmed. CONCLUSION: In addition to many artificial post-mortem alterations, chronic and acute diseases could be verified in Tutankhamun, although the underlying causes are partially unknown.

Feet and fabrication: footbinding and early twentieth-century rural women's labor in Shaanxi.

The early twentieth-century transformations of rural Chinese women's work have received relatively little direct attention. By contrast, the former custom of footbinding continues to fascinate and is often used to illustrate or contest theories about Chinese women's status. Arguing that for rural women at least, footbinding needs to be understood in relation to rural economic conditions, the authors focus on changes in textile production and in footbinding in two counties in Shaanxi province. Drawing on historical sources and their own interview data from rural women who grew up in this period, the authors find evidence that transformations in textile production undercut the custom of footbinding and contributed to its rapid demise.

Foot deformities in Renaissance paintings. A mystery of symbolism, artistic licence, illusion and true representation in five renowned Renaissance painters.

Although Renaissance artists were skilled in representing normal anatomy, a close look at some paintings reveals anatomical variations in the depiction of the feet of human figures. A systematic review has identified 25 paintings by five artists in which the presumptive medico-artistic diagnosis of congenital or acquired foot deformity seems to be varyingly present. The connection between these five painters and what factors have influenced artists' style in the depiction of such deformities is discussed. The possible iconography and medical-historical meaning of such variations, as well as the possibility of artistic licence and real representation that drove the painters to depict these deformities, is explored and debated.

Jean-Martin Charcot (1825-1893). The man behind the joint disease.

Jean-Martin Charcot was one of the most celebrated French physicians of the 19th century. A masterful teacher and a captivating lecturer, Charcot created the foundations of neurology as an independent discipline, and transformed the Salpêtrière hospital, in Paris, into one of the world's greatest teaching centers for clinical neurologic research. His name is attached to the distinct pathologic entity, Charcot's joint disease, that he so meticulously described. This article reviews the highlights of Charcot's career and his clinicoanatomic studies of patients with tabetic arthropathies.

Foot deformity of unknown etiology in a prehistoric skeleton from Texas.

An unusual foot deformity in an archaeological specimen from Oldham County, Texas, is presented. It is hoped that through description and radiographic and photographic examination the readers will be able to offer opinions concerning the frequency or possible etiology of the condition.

The normal foot.

The term "normal foot" has many different interpretations. This article reviews some of the ways in which the word "normal" has been used historically to describe the foot. Also discussed are the problems of attempting to determine what should constitute a normal foot and proposed criteria for distinguishing between the normal and the pathological.

Historical review and current use of the Whitman/Robert's orthoses in biomechanical therapy.

Current literature disputes Whitman's belief that muscle action plays the primary role in foot stability. Because of this faulty premise, Whitman included an excessively high medial flange in his orthosis. The high medial flange caused many patients a great deal of discomfort. To avoid this pain, the patients would not wear the brace, and as a result, it had little clinical value. For this reason, podiatrists seldom use the Whitman/Robert's orthosis unless it has been modified. Although Whitman constructed his brace under a false premise, it provided current researchers with a great deal of valuable information. Many aspects of the current foot orthosis were derived from Whitman's original work. The medial heel skive, for example, is very similar in function to the extrinsic varus wedging used by Roberts and the Thomas heel wedge used by Whitman. The Blake inverted orthotic also displays some conceptual similarities to the seldom-used Whitman/Robert's brace. Consequently, although Whitman did not fully appreciate the mechanisms that stabilize the foot, there is no question that his efforts had a profound effect upon the development of modern functional foot orthoses.

Secularizing the pain of footbinding in China: missionary and medical stagings of the universal body.

How did foreign Christian anti-footbinding activists treat the distinctive forms of human embodiment they encountered in China? What were their assumptions? How should we understand the transition from religious to secular imaginings of the body and its pains? Here I discuss late nineteenth and early twentieth century religion and medicalized hygiene through the voices of two English people who campaigned against and wrote extensively about footbinding. Not an easy story about God traded for Nature, but a far more uneasy and subliminal borrowing and cross-fertilization of tropes between the religious and the scientific. In both evangelical religion and biological science our protagonists created powerful narrative technologies for making cultural process disappear into nature, and thus to re-channel agency, making it available for new projects. Here we see the secular and the religious informing and reinforcing one another as moments in the creation of the modern.

[Historical development of arthrodesis of pes cavus]. / Korrigierende Arthrodesen des Klauenhohlfusses aus historischer Sicht.

In contrast to the present, the diagnosis and treatment of pes cavus was a major subject of research at the beginning of last century. This was due to the high incidence of certain neurological disorders (poliomyelitis, myelodysplasia) which led to the development of this foot deformity. Advances in anaesthetic technique and the establishment of antisepsis contributed largely to the development of the surgical treatment of pes cavus. Ladislaus Leo Freiherr von Lesser performed the first surgically induced ankylosis of the ankle by denuding the joint surfaces of cartilage followed by fixation with a metal nail. This procedure was then introduced as arthrodesis; a word derived from the Greek meaning "binding of the joint". Numerous methods and modifications of arthrodesis have been developed for the correction of foot deformities. With increasing knowledge of the pathogenesis of pes cavus, soft tissue and tendon transfer procedures were added to the surgical treatment. Today, the philosophy of arthrodesis in the treatment of foot deformity is the same, but the development of fixation techniques and implant materials could improve postoperative care and outcome.

A critical analysis of Dudley Morton's concept of disordered foot function.

The name Morton is associated with a foot structure characterized by a short first metatarsal in comparison with the adjacent second metatarsal. Dudley Morton is credited with recognizing a short first metatarsal as being a primary defect of the foot. Morton, an anatomist, approached his observation from an evolutionary perspective. His theory of disordered foot function was based on the premise that human alignment centered on an "axis of leverage" and around an "axis of balance." Morton concluded that the presence of a short first metatarsal was compounded when the first metatarsal segment was hypermobile. Shortness and hypermobility diminished the capacity of the first metatarsal segment to carry weight, allowed pronation during activity, and led to an overload of the central metatarsals. The term Morton Foot sprang from his teachings. The extensive writings of Morton are commonly cited even today. This study compares Morton's teachings with research published during the last 70 years, which either supports or refutes his claims.

[Foot surgery in Germany. Historical burden or scientific challenge?]. / Fusschirurgie in Deutschland. Historische Bürde oder wissenschaftliche Herausforderung?

In Germany foot surgery was established in the late nineteenth century. To correct foot deformities due to paralytic disorders, i.e., poliomyelitis, and congenital deformities, different types of tenotomies and arthrodeses were developed to obtain plantigrade weight-bearing and to avoid external orthosis. A description of surgical techniques during the last century is presented in detail. During those years resection arthroplasties for hallux valgus were common, although some authors recommended osteotomies of the first metatarsal as joint-sparing techniques. Nowadays, further knowledge in etiology, pathology, and biomechanics have effected the therapeutic algorithm in hallux valgus. Nevertheless, discussion about this topic has not come to an end. In 1991 the German Foot and Ankle Society (D.A.F.) was founded. Educational courses to improve surgical skills as well as clinical workshops were successfully established. A marked increase in membership and a broad international acceptance confirm these activities.

Historical vignette #9. Little big man: the life and genius of William John Little (1810-1894).

William John Little had in many respects a unique career. He suffered childhood poliomyelitis with residual left lower extremity paraparesis, complicated by severe talipes. As a youth he was an apothecary's apprentice, surrendering his indentures at the age of 18 and entering medical school at the London Hospital. He was admitted to the Royal College of Surgeons in 1832. He later travelled to Germany to study the technique of subcutaneous tenotomy with its originator, Louis Stromeyer, who subsequently corrected Little's deformed foot by this method. His doctoral dissertation (1837) was the first monograph on tenotomy ever published, and he became the apostle of this operation for the correction of skeletal deformity secondary to neuromuscular disease. Little founded the Royal Orthopaedic Hospital of London. Among his many publications was "On the Deformities of the Human Frame" (1853) in which he first described pseudohypertrophic muscular dystrophy (antedating Duchenne's paper by eight years), as well as cerebral spastic palsy (Little's Disease). The techniques originated by Stromeyer and applied by Little are used today in the surgical management of muscular dystrophy. William Little was one of the first to bridge the gap between neurology and orthopaedics and his important work continues to impact on both these fields.